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Can You Get a Flu Shot After Receiving Monoclonal COVID Antibody Therapy?

Since you are likely aware that you should likely wait 90 days until receiving a COVID vaccine after receiving monoclonal antibodies as a part of COVID treatment, you might also be wondering if you should wait to get a flu shot or other vaccines.

Fortunately, the answer is no, you do not have to wait.

Can You Get a Flu Shot After Receiving Monoclonal COVID Antibody Therapy?

Why the difference in recommendations?

With the COVID vaccine, the concern is that the monoclonal antibodies might interfere with the vaccine itself and keep you from making your own antibodies. And since you are unlikely to develop a breakthrough infection in the first 90 days after a natural COVID infection, the recommendation is to wait.

“Currently, there are no data on the safety and effectiveness of COVID-19 vaccines in people who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment. Based on the estimated half-life of such therapies and evidence suggesting that reinfection is uncommon within the 90 days after initial infection, vaccination should be deferred for at least 90 days after receiving monoclonal antibodies or convalescent plasma for treatment. This is a precautionary measure until additional information becomes available, to avoid potential interference of the antibody therapy with vaccine-induced immune responses.”

Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States

Why don’t the monoclonal antibodies interfere with other vaccines?

The monoclonal antibodies that are used to treat and prevent COVID-19 are specific to different parts of the SARS-CoV-2 spike protein. They won’t interfere with the flu vaccine or any other vaccines.

What about other antibody therapies, like COVID-19 convalescent plasma and SARS-CoV-2 IVIG?

In general, there are recommendations to delay some vaccines for at least 3 to 11 months after getting treated with IVIG, but it depends on which immune globulin (IG) product you received and the dose.

IVIG and convalescent plasma contain polyclonal antibodies, a mix of antibodies.
IVIG and convalescent plasma contain polyclonal antibodies, a mix of antibodies.

For example, while you would typically delay getting the MMR and Varicella vaccines for at least three months after getting tetanus immune globulin, the delay would be five months if you received VariZIG (chicken pox immune globulin), and 11 months if you got IVIG as therapy for ITP or Kawaskai disease.

“Administration of IG preparations does not interfere with antibody responses to yellow fever, oral poliovirus (OPV), or oral rotavirus vaccines and is not expected to affect response to live-attenuated influenza vaccine. Hence, these live vaccines can be administered simultaneously with or at any time before or after administration of IG. 

In contrast to the effect on some live-virus vaccines, administration of an IG preparation does not significantly inhibit the immune responses to inactivated vaccines or toxoids.”

Red Book – Active Immunization of People Who Recently Received Immune Globulin and Other Blood Products

And as you likely noticed, only a few live vaccines are typically delayed – notably the MMR and chicken pox vaccines.

So yes, the flu shot, and even FluMist, the live attentuated nasal spray flu vaccine, both can be given after you have received any of these antibody treatments for COVID.

“If you are not feeling well, talk to your doctor about your symptoms.”

Who Should and Who Should NOT Get a Flu Vaccine

The only delay might be that you wait until you are feeling better after your COVID infection and you are past your isolation period, so are no longer contagious!

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